Concept Analysis

Concepts play an important role in the development of nursing theories, which are applied in research and practice. Therefore, concepts are useful when evaluating nursing theories since their analysis shows how a particular theoretical framework was conceived. Various concepts are useful in nursing theory, and self-care is among them. The theory relates to the importance of having empowered patients to support the effectiveness of disease management. Using the model, nurses can help patients to become central in the treatment and management process, especially in chronic conditions such as diabetes (Afrasiabifar, Mehri, Sadat, & Shirazi, 2016). The concept is also at the core of patient-centered care because of the critical role that patients play in their care. Orem’s self-care model uses the concept of self-care to define the role of a nurse and patient in the continuum of care. In this discussion, the analysis will entail various sections, including a definition/explanation of self-care, a review of literature, a definition of attributes, antecedent and consequence, empirical referents, construct cases, and a conclusion. Although many concepts in nursing theory exist, self-care is at the core of achieving quality in the management of complicated chronic diseases.

Definition/Explanation of Self-Care

Health care providers, including nurses, apply the concept of self-care to improve patient experience and achieve positive outcomes. It is used to place patients at the core of the care process by empowering them to take control of their health. According to Hasanpour-Dehkordi (2016), “beliefs, individual characteristics, the relationship between the treatment team and patient, and patient’s sociocultural background” affect self-care behaviors (p. 389). Therefore, care providers should understand patient traits that affect their health, such as knowledge, age, and self-efficacy. Nurses should appreciate how such factors promote or hinder health behaviors among patients (Holden, Schubert, & Mickelson, 2015). Consequently, patients with the ability in terms of age, have sufficient understanding, and those with high self-efficacy are capable of self-care.

Literature Review

Attributes of Self-Care

Research reveals various attributes of self-care. One of the attributes is the association between nurses and patients, which affects health outcomes (Hasanpour-Dehkordi, 2016). The family also plays a critical role in providing the necessary social support to achieve self-care. Patients with adequate social support tend to have greater self-efficacy compared to those who lack close relationships.

Self-reliance and self-monitoring are important attributes in self-care. The self-monitoring process is part of disease management and plays a critical role in ensuring accountability among patients (Hasanpour-Dehkordi, 2016). Self-reliance is about the ability to observe positive behavior when one has a chronic disease such as diabetes. It relates to the understanding of the things the patient should do or avoid to prevent negative outcomes.

Another attribute is knowledge, which is important in achieving self-care. Patients should understand their conditions and treatment models to manage their ailments (Chen et al., 2014). Therefore, nurses should train and educate patients on the disease and treatment interventions (Hasanpour-Dehkordi, 2016). Besides, they should have the relevant knowledge to achieve self-care. Nurses should understand the importance of knowledge in supporting self-care.

Antecedent and Consequence

The concept of self-care relates to the challenges affecting the current healthcare environment, such as the shortage of nurses and the increasing cost of care. At the same time, the population is aging, and chronic diseases are on the increase. For instance, heart failure has a prevalence rate of 0.4% to 2.4% in the U.S. and Europe (Vellone et al., 2013). Chronic diseases advance constant visits to the ER and other outcomes, such as admission and prolonged hospital stay. Furthermore, the effects increase the cost for individuals, hospitals, and the country. Therefore, as a consequence, self-care enhances the quality of care, reduces hospital visits and admissions, and reduces costs for individuals and the health care system.

Empirical Referents

The identification of empirical referents is an important part of concept analysis. Enhanced efficacy and patient outcome are the sources of subjective proof of effectiveness in self-care (Delgado et al., 2014). Nurses are expected to support holistic learning through management models. Patients are more satisfied when they have better control over their health, an aspect that reduces the need for primary care (Hasanpour-Dehkordi, 2016). Furthermore, nurses report being more satisfied when they have less work and have satisfied patients (Delgado et al., 2014). They experience better work satisfaction, which shows that nurses and their patients are positively affected by self-care principles.

Improved health outcomes and reduced cost of care are the objective empirical referent in the application of the self-care model. The model supports a reduction in health facility visits, which has positive social and economic effects (Delgado et al., 2014). There are various other benefits of self-care, including a decrease in stress, the achievement of a positive lifestyle, and cost-reduction in the management of chronic diseases (Hasanpour-Dehkordi, 2016). Healthcare facilities also benefit from increased patient satisfaction, cost-reduction, and staff retention.

Construct Cases

Model Case

An individual with a heart condition requires constant health care and always visits the health care center for medications. The patient was advised about the need to take care of herself because her heart is delicate. When the diagnosis was made, she constantly visited the hospital to have tests regarding the condition. However, nurses at the hospital trained the patient about how to remain stable, including having an appropriate exercise plan, proper diet, and reducing stress levels. Collaboratively, the nurse worked with the patient to develop a self-care plan. The patient eventually reduced the level of heart attack risk, the number of hospital visits, and eventually, the cost of care.

Borderline Case

A patient suffering from obesity requires constant hospital visits because he keeps gaining weight. The practitioner realizes that the patient keeps consuming high caloric diets. The physician has been prescribed medications, but one attribute of self-care is lacking. The patient does not have adequate knowledge about the diet and foods he should avoid to remain healthy.

Contrary Case

An older woman has diabetes as a result of continued consumption of an unhealthy diet,  regardless of a positive diagnosis made two years ago. The older adult lives with her aged husband who lacks the competence to support her health management plan. She misses her appointments with her primary care provider because she has no one to remind her. Her memory is declining, which means that she lacks control over what she consumes. Her condition is worsening.

Theoretical Applications of the Concept

Nursing concepts are the building blocks of health. Self-care derives from Orem’s self-care model and defines three important requirements: universal, developmental, and health deviations. Universality relates to the integrity of humanity in nursing. The developmental concept relates to the state of nature in a healthy lifestyle. Health deviations relate to the occurrence of illness (Çapik, Nazik, & Özdemir, 2015). The theoretical model and the concept emerge from the need to empower individuals to take care of their health and manage disease conditions (Afrasiabifar et al., 2016). Orem’s self-care remains critical in the understanding and application of self-care in health care settings. Health care practitioners work with their patients to develop the necessary knowledge to manage and monitor their health (Afrasiabifar et al., 2016). Practical evidence shows that the theory is being used in the current health care organizations to address the problem of the nursing shortage and increase the cost of care in the country. Besides, it is important in the management of complex health care conditions such as chronic ailments such as diabetes (Çapik, Nazik, & Özdemir, 2015). According to Afrasiabifar et al. (2016), the evidence is available in people with “congestive heart failure, bronchial asthma, end-stage renal disease, cystic fibrosis, acquired immune deficiency syndrome (AIDS), and diabetes using Orem’s model” (Afrasiabifar et al., 2016, p. 2). Thus, self-care has major benefits to patients, nurses, and the overall health care system. Patients with chronic conditions have a positive outcome if they have the self-efficacy and knowledge to manage their conditions.

Conclusion

Nursing concepts are important to theory, research, and practice. They are the foundation for the major nursing theories used in the contemporary health care setting. One such theory is self-care, whose analysis provides important knowledge on how to empower patients to have control over their health and the management of diseases. The concept emanates from Orem’s theory, which suggests the important role of patient and social relationships in promoting care. The theory achieves positive outcomes for patients and nurses, especially in the management of chronic conditions such as diabetes.